Overview: Neurofeedback has the potential to alleviate symptoms of “brain fog” and cognitive impairment associated with chemotherapy.
Restoring normal functioning in the brains of cancer patients through neurofeedback could potentially alleviate the mental fogginess that many report after treatment, according to a new pilot study from UCLA researchers.
The study is one of the first to indicate that neurofeedback, or electroencephalogram (EEG) biofeedback, could help address cognitive deficits in cancer patients experiencing “chemo brain,” a host of symptoms that cause problems with memory, concentration and organization, as well as other symptoms such as sleep problems and emotional problems.
Previous research has shown that neurofeedback, which involves training brain waves to operate in optimal frequency patterns, has helped to improve cognitive function in patients with cognitive impairments such as attention deficit hyperactivity disorder, stroke and seizures, and has helped regulate the brain activity in patients with substance use and post-traumatic stress disorder.
“The history of neurofeedback shows that it helps with a whole range of conditions and symptoms. This study was an opportunity to see if neurofeedback is something that could be helpful in chemobrain,” said Stephen Sideroff, a professor in UCLA’s Department of Psychiatry and Biobehavioral Sciences who led the study and has used neurofeedback training in patients for more than 20 years. .
The research was published this month in the Journal of Complementary and Integrative Medicine.
The study by Sideroff and UCLA colleagues David Wellisch and Valerie Yarema included nine female breast cancer patients between the ages of 21 and 65 who had undergone chemotherapy at least a year before and complained of debilitating chemo brain symptoms, causing significant disruptions to their work and personal lives.
A clinical nurse conducted a brief mental status interview with each patient to confirm that they had persistent problems with concentration, memory, organization and confusion.
The patients selected for the study did not have a current diagnosis of breast cancer, a current or recent diagnosis of major depressive disorder or other mental illness, or were taking cognitively altering medications that could interfere with the study results.
Before the neurofeedback training sessions began, the study participants received neurocognitive and psychological tests, as well as a quantitative EEG to measure brainwave frequencies that could be compared with normative data. The pre-training quantitative EEGs show that each study participant had abnormal brain-release activity compared to healthy adult brains.
The study participants received a series of 18 neurofeedback sessions, each lasting 30 minutes, over a six-week period. During these sessions, sensors were placed on the scalp and earlobe to monitor brainwave frequencies.
Patients were shown a monitor that displayed these frequencies in bar graphs, and were told their goal was to increase or decrease the amplitude of specific frequency ranges to make each bar green. They received audio and visual feedback when they successfully shifted these amplitudes.
Quantitative EEGs taken after the 18 neurofeedback sessions were completed showed that brainwave frequencies had significantly normalized in seven of the nine study participants, and that they had improved significantly in the other two.
Neurocognitive tests conducted after the neurofeedback sessions showed substantial improvements in the study participants’ information processing, executive set shifting, and sustained visual attention. Each improved in daily functioning and had general psychological improvement.
Study limitations include a small sample size and the lack of a control group. Another limitation was the extended window required for most study participants to undergo all 18 neurofeedback sessions. Three completed the training in the scheduled six-week window, while most took between seven and nine weeks. Previous research on neurofeedback has shown that the therapy is more effective when sessions are held closer together.
“Our results are more impressive because we couldn’t keep the subjects on schedule,” Sideroff said.
Sideroff said the study results were strong enough to support further research into whether neurofeedback is an effective approach for targeting brain chemo and determining the ideal protocols for conducting neurofeedback training sessions.
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“A neurotherapy protocol to remedy cognitive deficits after adjuvant chemotherapy: a pilot study” by Stephen Sideroff et al. Journal of Complementary and Integrative Medicine
A neurotherapy protocol to overcome cognitive deficits after adjuvant chemotherapy: a pilot study
Adjuvant chemotherapy for breast cancer is undeniably effective at increasing survival, but many breast cancer (BCS) survivors show side effects such as nausea, fatigue, stress and neurocognitive impairment, also known as ‘chemobrain’.
This pilot study examined how neurotherapy, or EEG biofeedback, a non-pharmacological approach improved neurocognitive, behavioral and neurophysiological deficits associated with BCS undergoing chemotherapy.
The subjects underwent 18 sessions of EEG biofeedback training, during which audio and visual feedback occurred with successful shifting of EEG patterns.
Quantitative EEG and assessment tests demonstrated neurophysiological, cognitive, and behavioral impairment in all nine subjects before training. Post-training EEG biofeedback resulted in significant improvements in neurophysiological, neurocognitive and psychological functions in all nine subjects.
We propose that this intervention and related forms of EEG biofeedback have the potential to significantly alleviate common side effects of chemotherapy in BCS and therefore deserve additional research attention.